Allergy Unit, department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy.
Department of Veterinary Science, University of Pisa, Pisa, Italy.
Ital J Pediatr. 2019 Aug 17;45(1):102. doi: 10.1186/s13052-019-0700-4.
The therapeutic strategy for children with cow's milk allergy (CMA) consists in the elimination of cow's milk (CM) from their diet. Donkey's milk (DM) has been reported to be an adequate alternative, mainly to his nutritional similarities with human milk (HM) and excellent palatability. The aim of present prospective study was to evaluate the nutritional impact of DM on the diet of children with CMA in term of children growth.
Before the nutritional trial on children and during the study the health and hygiene risks and nutritional and nutraceuticals parameters of DM were monitored. Children with CMA were identified by the execution of in vivo and in vitro tests for CM and subsequent assessment of tolerability of DM with oral food challenge (OFC). Finally, we prescribed DM to a selected group of patients for a period of 6 months during which we monitored the growth of children. A total of 81 children, 70 with IgE mediated cow's milk protein allergy (IgE-CMPA) and 11 with Food Protein Induced Enterocolitis Syndrome to CM (CM-FPIES), were enrolled.
Seventy-eight out of 81 patients underwent the OFC with DM and only one patient with IgE-CMPA (1.5 %) reacted. Twenty-two out of 81 patients took part of the nutritional trial. All the 22 patients took and tolerated the DM, moreover DM did not change the normal growth rate of infants.
In conclusion, DM resulted safe in term of health and hygiene risks and nutritionally adequate: no negative impact on the normal growth rate of children was assessed. Therefore, it may be a suitable alternative for the management of IgE mediated CMA and FPIES, also in the first 6 months of life, if adequately supplemented.
儿童牛奶过敏(CMA)的治疗策略包括从饮食中消除牛奶(CM)。驴奶(DM)已被报道为一种合适的替代品,主要是因为它与母乳(HM)在营养上相似,且味道极佳。本前瞻性研究的目的是评估 DM 在儿童 CMA 饮食中的营养影响,主要是从儿童生长方面评估。
在对儿童进行营养试验之前和研究期间,监测了 DM 的健康和卫生风险以及营养和营养保健品参数。通过执行体内和体外试验来识别 CMA 儿童,并对 DM 的耐受性进行口服食物挑战(OFC)评估。最后,我们为选定的一组患者开了 DM 处方,为期 6 个月,在此期间监测儿童的生长情况。共纳入 81 名儿童,70 名有 IgE 介导的牛奶蛋白过敏(IgE-CMPA),11 名有对 CM 的食物蛋白诱导性肠炎综合征(CM-FPIES)。
81 名患者中有 78 名接受了 DM 的 OFC,只有 1 名 IgE-CMPA 患者(1.5%)出现反应。81 名患者中有 22 名参加了营养试验。所有 22 名患者均接受并耐受了 DM,此外,DM 并未改变婴儿的正常生长速度。
总之,DM 在健康和卫生风险以及营养方面是安全且充足的:没有评估到 DM 对儿童正常生长速度的负面影响。因此,如果进行适当补充,它可能是 IgE 介导的 CMA 和 FPIES 管理的合适替代品,甚至在生命的前 6 个月也是如此。